However, if you have too much “bad” cholesterol, called low-density lipoprotein (LDL), or too little “good” cholesterol," called high-density lipoprotein (HDL), it can contribute to serious health problems like heart disease.
Even if you are on medications to control your cholesterol, you may find that other drugs you take can reduce their effectiveness. In some cases, your doctor may need to adjust the dosage of one or both drugs to get your cholesterol back under control.
This article looks at some of the more commonly prescribed drugs that are known to affect cholesterol levels and what can be done if this occurs.
Beta Blockers
Beta blockers are medications that are normally prescribed to treat high blood pressure. Though they’re commonly used to treat different forms of heart disease, beta blockers can significantly reduce HDL levels.
Among the beta blockers that cause this are:
Corgard (nadolol)Inderal (propranolol)Tenormin (atenolol)Toprol (metoprolol)Zebeta (bisoprolol)
Despite these concerns, the benefits of beta blockers usually outweigh the risks (and the effects, if any, tend to be small). If your beta blocker affects your cholesterol significantly, your doctor may lower your dose or switch you to a different medication.
Prednisone
Prednisone is a type of drug use to reduce inflammation. It belongs to a class of drugs called corticosteroids and is used to treat a wide range of inflammatory conditions, including severe allergic reactions, certain types of arthritis, lupus, multiple sclerosis, and inflammatory bowel disease (IBD).
Prednisone is incredibly effective in reining in inflammation but can also quickly and sometimes dramatically raise LDL levels and lower HDL levels. Studies suggest that high-dose prednisone can cause this in a matter of weeks and increase your systolic blood pressure at the same time.
Prednisone is generally prescribed for severe inflammatory conditions when the benefits of treatment outweigh the risks. The risk of side effects increases with dose and duration of treatment.
Amiodarone
Amiodarone is a drug used to treat a condition known as cardiac arrhythmia. Cardiac arrhythmia is an irregular heartbeat caused when electrical signals in heart muscles aren’t working properly. This can cause the heart to beat too quickly (tachycardia), too slowly (bradycardia), or erratically.
Amiodarone is associated with a wide range of side effects. Among them, amiodarone can cause LDL levels to spike, although it generally doesn’t affect HDL levels.
Amiodarone is generally used to treat life-threatening arrhythmias or to prevent or treat heart rhythm disorders in people at risk of heart attack and other serious complications. Because of this, its effects on cholesterol are rarely significant enough to avoid the use of the drug.
Cyclosporine
Cyclosporine is a type of drug known as an immunosuppressant. These work by reducing the response of the immune system, which fights infections, diseases, and anything else it considers abnormal.
Cyclosporine is used to prevent organ rejection, in which the immune system attacks donated tissues. It can also be used to treat autoimmune diseases, a group of conditions where the immune system mistakenly attacks the body’s own tissues.
Cyclosporine has many side effects, one of which includes an increase in LDL levels. Even so, its benefits for preventing organ rejection or treating autoimmune diseases generally outweigh these concerns. If needed, cholesterol-lowering medications can be prescribed to counter this effect.
Anabolic Steroids
Anabolic steroids are a group of male sex hormones, including testosterone, that are used illegally by weightlifters and athletes to build muscles. But, they also have legitimate medical uses, including treating certain types of anemia (a lack of oxygen-carrying red blood cells) or a condition called hypogonadism in which the body does not produce enough testosterone.
Anabolic steroids can cause a dramatic increase in LDL levels and decrease HDL levels. With long-term use, this can increase the risk of atherosclerosis (“hardening of the arteries”), high blood pressure, and coronary artery disease as well as type 2 diabetes.
Interestingly, oral forms of the drug tend to affect cholesterol levels more than injected forms.
Protease Inhibitors
Protease inhibitors are a class of antiretroviral drugs used to treat HIV. They are used in combination with other HIV drugs and work by preventing the virus from making copies of itself.
Protease inhibitors used for the treatment of HIV include:
Aptivus (tipranavir)Evotaz (atazanavir/cobicistat)Kaletra (lopinavir/ritonavir)Lexiva (fosamprenavir)Norvir (ritonavir)Prezcobix (darunavir/cobicistat)Prezista (darunavir)Reyataz (atazanavir)
Protease inhibitors have long been associated with changes in both cholesterol levels and body fat. The effects were greater with earlier protease inhibitors like Crixivan (indinavir), Invirase (saquinavir), and Viracept (nelfinavir), all of which have been discontinued in the United States.
The drugs that are now available can still affect cholesterol levels in some people. Even so, the use of these life-saving drugs overrides these concerns. If needed, anti-cholesterol drugs can be used, along with diet and exercise, to bring cholesterol levels back under control.
Diuretics
Diuretics, also known as “water pills,” are used to treat high blood pressure and water retention. There are two types of diuretics that increase cholesterol levels:
Thiazide diuretics, including Diuril (chlorothiazide), Zaroxolyn (metolazone), and hydrochlorothiazideLoop diuretics, including Lasix (furosemide), Demadex (torsemide), and Bumex (bumetanide)
Thiazide diuretics cause a temporary increase in total cholesterol and LDL levels; HDL levels are typically unchanged. Currently, Lozol (indapamide) is the only thiazide diuretic that does not appear to affect cholesterol levels.
Loop diuretics also increase LDL levels, but some of these drugs also cause a slight decrease in HDL levels.
Summary
There are many drugs that can affect your cholesterol levels. Some can raise your “bad” LDL cholesterol, decrease your “good” HDL cholesterol, or both. These include medications like beta blockers, prednisone, amiodarone, cyclosporine, anabolic steroids, HIV protease inhibitors, and diuretics.
If these drugs are medically needed and used as prescribed, their benefits will generally outweigh the risks in terms of your cholesterol. If the effects are significant enough, cholesterol-lowering drugs can be prescribed or the dose adjusted if you are already on treatment.
In some cases, a drug can be switched if the effects on your cholesterol are serious enough, including certain beta blockers or diuretics. Your doctor may also advise you to exercise and change your diet to bring your cholesterol back under control.
A Word From Verywell
If you have high cholesterol or any other chronic health conditions, it is important to let your doctor know about any medications you take, including prescription drugs, over-the-counter medications, and nutritional supplements. Some drugs can potentially affect your cholesterol levels or interact with your anti-cholesterol drugs and make them less effective.
